Postpartum Depression – Feeling Blue

Many new mothers are surprised by the emotional highs and lows they can experience in the days after birth. Your baby is healthy, you survived childbirth and you’re on maternity leave. So what’s the problem? The truth is that feelings of sadness and anxiety are experienced by almost all women after giving birth, especially with a first baby.

New mothers are rarely aware of what things will be like after taking the baby home. They often have ideal expectations: a calm, quiet baby, a happy husband/partner, and time for everyone.It can be a shock when the baby cries more than expected, doesn’t sleep as much – or when – you expected, your partner feels left out and you barely have enough time to have a shower. The reality can make a woman feel let down, that she may have made a mistake by having a child. She may feel she doesn’t know how to cope.

Baby Blues

Up to 75 per cent of women experience transient mood changes in the immediate postpartum period. This is often called the ‘baby blues.’

Feelings that come with ‘baby blues’ may include sadness, negative feelings toward the baby, fatigue, anxiety, insomnia and an overall sense of unhappiness. These feelings may last for as little as a few hours during your hospital stay or for up to a week or two.

No specific cause for the baby blues has been found, although most experts blame changing hormones. And although there is no specific treatment for the baby blues, plenty of rest, honest communication, support from your partner, family and friends, and growing experience with motherhood seem to help for most women.

Sometimes, you may feel that no one understands how you’re feeling. You may be embarrassed to admit you’re not coping as well as you had imagined, and that sometimes you feel out of control.

At the same time, it can be difficult for your partner to understand why you’re not responding more positively to him and to motherhood in general.

Fathers typically don’t have the same degree of change in their lives as mothers when the baby arrives. While there are more responsibilities and less time together as a couple, his life is not turned upside down to the same extent.

It can be unhealthy for a woman to hide sad and anxious feelings, and may prolong a situation that could be improved with some outside help.

Postpartum Depression

If your feelings of unhappiness persist and/or get worse, you may be experiencing postpartum depression (PPD). Between 10 and 15 per cent of women experience this.

PPD can be defined as feeling sad, unhappy or depressed for more than two weeks. Symptoms are similar to the ‘baby blues,’ but they are more intense and they continue. Examples are: waking early in the morning, insomnia, an increase or decrease in appetite, crying, a lack of energy, chronic exhaustion, total loss of interest in sex, withdrawal from friends and family and, in extreme cases, having thoughts of harming yourself or your baby.

If you experience these symptoms, seek help as soon as possible. A visit to your doctor, midwife or community health nurse is a good starting point.

If you feel suicidal, talk to someone who will really listen. (A close family member, not understanding your inner turmoil, may not take you seriously or may minimize your concerns.)

PPD responds well to a variety of treatments, which include counseling or psychotherapy, and, if necessary, antidepressant medication.

Psychotherapy or counseling may be short-term, such as ‘supportive therapy’ to get you over the really tough times, or in the long-term, such as ‘insight therapy’ which explores the impact postpartum depression is having on your life and well-being.

New mothers can usually find comfort and healing through postpartum support groups, in which they can connect with other women experiencing PPD. Contact your local community/public health department to find out about groups in your area.

Similar parenting groups may operate through local community centres, religious organizations or the YWCA.

A postpartum fitness class may help not only by providing exercise that benefits your physical and overall health, but by giving you a chance to meet other mothers who may share your experience.

The Role of Medications

Only take medications your doctor prescribes or advises you to take.

For example, anti-depressant medications are typically prescribed as a last resort – when the benefits outweigh the risks or side effects. Some women who have taken medication report feeling a genuine ‘lifting of the burden’ which is enough to help them feel human again. Your doctor may then refer you to or suggest a support group to help smooth the way while the medication is gradually lowered.

If you breastfeed, make sure you ask your doctor whether you can continue to breastfeed when you take prescribed medication.

Postpartum Psychosis

This is an extremely rare but severe psychiatric illness experienced in the postpartum period (one to two cases per 1,000 live births). It is defined as a state of being out of touch with reality. Postpartum psychosis may be characterized by hyperactivity, speedy thoughts and an abnormally elevated mood. Hallucinations often accompany this disorder. Postpartum psychosis requires hospitalization, usually under the care of a psychiatrist. Use of medication usually means a longer hospitalization.

Your Relationship

Relationship dynamics change a lot with a new baby. Many couples aren’t prepared for the demands of parenthood. Even previously stable marriages are tested.

Your husband/partner may not be able to fully appreciate your rearranged life, and may become aloof, distant, uninvolved, and even look for excuses to stay away. At the same time, you may find yourself blaming him for putting you in this situation. Under these circumstances, it’s hardly surprising if you don’t feel like being intimate.

It’s important to acknowledge these changing feelings together and work through them in a positive way, rather than hoping that things will just get better on their own.

Feeling Good Again

There is life after childbirth. Things usually smooth out in six to eight weeks. You’re going through a lot:

Your body is returning to its pre-pregnancy state.

You and your baby are just beginning to understand each other’s rhythms.

Your body may be the sole nourishment for your baby.

Your baby wakes up many times before you are ready to get up. You’ll get better at coping as you adapt to new parenthood. BW